Tag: ppaca

Targeting the Tea Party Isn’t the IRS’s Most Egregious Abuse of Power

Not by a longshot. 

As Jonathan Adler and I explain in this law journal article, and as I explain somewhat more accessibly in this Cato paper, the IRS is trying to tax, borrow, and spend $800 billion in clear violation of federal law and congressional intent.

Yes, you read that right: $800 billion.

Benghazi? Let’s Talk ObamaCare!

Things must be going poorly for President Obama if he wants to change the subject to ObamaCare.

Today, most of Washington is questioning whether the U.S. government was derelict in its handling of the September 11, 2012 assault on the U.S. consulate in Benghazi, Libya, in which heavily armed assailants injured 10 Americans and murdered four, including the U.S. ambassador. However, over at the White House, President Obama is launching a PR defensive of ObamaCare, at which he will basically ask mothers to nag their kids to waste their money on ObamaCare’s over-priced health insurance

The contrast brought to mind this passage from University of Chicago law professor M. Todd Henderson’s article in the latest issue of Cato’s Regulation magazine:

When the president sought to make birth control a mandatory part of all insurance plans, this was a political decision regarding health care. This is not to disparage political decisions in general, but merely to point out this feature of them, that they bind those who disagree…

A relatively simple, low cost, and widely accepted practice like birth control became a firestorm when individual choice and local variation were overridden on the grounds of improving social welfare. The airwaves and print media were filled with analysis, name-calling, and hyperbole. Kitchen tables, like my own, were filled with debate about how we should vote about the financing of other peoples’ use of birth control… Just imagine what the debates will look like when the stakes become—as they inevitably will—whether expensive cancer therapies, surgeries, or other procedures will be paid for, or whether more controversial matters like abortion, gender reassignment, and the like will be paid for…

When … matters are decided by experts or politicians, mistakes can be made and made in ways that necessarily are coercive. This coercion does not admit easy exit, as one can exit an insurance policy, especially if done at the federal level. The central lesson is that centralized power over complex matters risks making larger mistakes than decentralized power, admits less innovation, provides for less tailored satisfaction of preferences, and generates greater political conflict. Ironically, those risks may undermine the important work that government must do to improve the world we live in.

Every minute the government spends trying (and failing) to improve people’s health is a minute it cannot spend making them safer.

Read the rest of Henderson’s article, “Voice and Exit in Health Care Policy.”

Strange Things Are Afoot at the Circle K

The Washington Free Beacon reports:

Circle K Southeast joined a growing list of national companies shifting workers to part-time status this week, in order to avoid paying Obamacare’s mandatory benefits, CBS-WTOC reports.

The alternative is to pay a $2,000 fine per fulltime worker who is not covered, leading Circle K to become the latest in a long line of companies to slice employee hours to avoid increased costs.

Here’s the video:

NYT Room for Debate: the Oregon Medicaid Study & ObamaCare

Today’s New York Times Room for Debate” feature poses the question, “Do the mixed results of an Oregon health care study show that government medical insurance should provide only catastrophic coverage?” From my contribution:

ObamaCare aims to cover 16 million poor uninsured adults through Medicaid, plus 16 million higher-income uninsured Americans through government-subsidized “private” insurance. Supporters portrayed these “reforms” as a matter of life and death, particularly for the poor. Yet a monumental new study finds that “Medicaid coverage generated no significant improvements in measured physical health outcomes” for poor adults. These findings strengthen the case that states should stop implementing ObamaCare, and Congress should swiftly repeal it…

The absence of physical-health improvements indicts the entire enterprise. Supporters have an obligation to show that the $2 trillion in entitlements ObamaCare will launch next year would actually improve enrollees’ health. The Oregon study shows they cannot meet their burden of proof. What part of “no discernible improvement” don’t they understand?

Read the whole thing here. See also the contributions by Drew Altman, Austin Frakt, Robert Reich, and Grace-Marie Turner.

Wyden, Starr, Other ObamaCare Supporters Worry about Rollout

From Reuters:

“There is reason to be very concerned about what’s going to happen with young people. If their (insurance) premiums shoot up, I can tell you, that is going to wash into the United States Senate in a hurry,” said Senator Ron Wyden, an Oregon Democrat…

“Why in late April can’t they show us any of what they’ve got planned? The rollout plan should already be in existence,” an exasperated Democratic Senate aide said separately…

Reform is facing challenges on several fronts. Big insurers appear wary of participating, raising questions about how competitive the exchanges will be. Businesses are mounting a new legal effort to stop the use of federal subsidies in exchanges run by Washington. And most states have balked at the exchanges and the Medicaid expansion…

“I don’t see how what they’re planning to do is going to be adequate. The resources are too limited, the (law’s) penalties are too weak and elite opposition in much of the country will undermine” enrollment, said Paul Starr, a Princeton professor and former health adviser to President Bill Clinton…

An April survey of 1,003 people by HealthPocket, an online company that helps consumers find insurance, also found that the law’s penalty for not buying coverage would not induce most 25-to-34-year-olds or 18-to-24-year-olds to purchase it…

 

A Question for Medicaid Deniers

A lot of people are writing about the Oregon Health Insurance Experiment results, released yesterday, which found zero evidence that expanding Medicaid to the most vulnerable people targeted by ObamaCare’s Medicaid expansion improves their physical health. Here’s my take on the study and its implications. Megan McArdle, Shikha Dalmia, Avik Roy, and Peter Suderman are making solid contributions to the debate. Zeke Emanuel gets points for making an admission against interest (“It’s disappointing”). Points also to Jennifer Rubin for her take on what the OHIE says about ObamaCare’s Medicaid expansion: “If there had been a giant trial of a heart medication with lousy results we wouldn’t proceed in mass-marketing the drug; we might even take it off the shelves.” Not a bad idea. Ezra Klein and Evan Soltas call for more such experiments. Yes! Let’s have more randomized, controlled trials of the effects of Medicaid, on pre-ObamaCare populations, in big states like California, New York, Texas, Florida, and Illinois, where we can harnass even more statistical power. The only unethical thing would be to keep spending trillions on this program without knowing whether it’s even effective (much less cost-effective).

Others are making less-solid contributions. Here’s a question for them.

Since the OHIE shows that Medicaid makes no difference in the diagnosis or use of medication to treat high blood pressure or high cholesterol, and has no effect on blood-sugar levels despite increasing diabetes diagnoses and medication use, would you support eliminating Medicaid coverage for these screenings and medications?

If not, why not?